CPT code 78429: Cardiac PET, single metabolic study with CT2026 Medicare rate & RVUs in Missouri
A single-study cardiac PET metabolic examination with CT supports myocardial evaluation, including assessment of viability in ischemic heart disease.
CMS doesn’t publish an office rate for 78429 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 78429 covers
This service is a cardiac PET examination that evaluates myocardial metabolism in one study, with a concurrently acquired CT transmission scan for attenuation correction and anatomical localization. It may be used to assess myocardial viability, including in patients with ischemic left ventricular dysfunction. Nuclear medicine and cardiology practices and hospital imaging departments may provide the technical service, while a qualified physician interprets the images.
Medicare assigns this CPT code carrier-priced status: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. Modifier 26 identifies the physician’s interpretation, and modifier TC identifies the equipment and staff portion. Reporting without either modifier represents the global service. Choose a different code when the examination evaluates perfusion or uses a different study protocol.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 78429 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
How the 78429 rate is calculated
Each of 78429’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 78429
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78429
The CMS indicators that decide how 78429 is paid alongside other services.
CMS payment indicators · 78429
Cardiac PET, single metabolic study with CT
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
78429 without 26 · national facility
$0.00
Cardiac PET, single metabolic study with CT
78429-26 · Professional component
$77.82
Pays only the interpretation and report.
78429 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 78430Myocardial PETRest and stress with CT
- 78430 describes a single PET perfusion study with CT. Choose 78429 when the study evaluates myocardial metabolism.
- 78433Myocardial PETTwo radiopharmaceuticals
- 78433 is the two-radiotracer cardiac PET code with CT; 78429 describes a single metabolic study with CT.
- 78459PET myocardial imagingSingle metabolic study
- 78459 describes a single-study myocardial metabolic PET examination without the CT transmission scan included in 78429.
- 78431Cardiac PETRest and stress with CT
- 78431 describes cardiac PET perfusion imaging at rest and stress with CT, rather than a single metabolic PET study.
78429 billing questions
When should 78429 be selected instead of 78430?
Use 78429 for a single PET study evaluating myocardial metabolism with CT. Code 78430 describes a single cardiac PET perfusion study with CT.
How does 78429 differ from 78433?
78429 describes a single metabolic PET study with CT. Code 78433 is the two-radiotracer cardiac PET code with CT.
Can the professional and technical portions be reported separately?
Yes. Modifier 26 identifies the interpretation, and modifier TC identifies the equipment and staff portion. Without either modifier, the claim represents the global service.
What does Medicare's carrier-priced status mean for 78429?
CMS publishes no national payment for this code. The Medicare Administrative Contractor sets payment for each claim.
What should the record support when reporting 78429?
The record should support a single cardiac PET metabolic study with a concurrently acquired CT transmission scan. The code is distinct from cardiac PET perfusion imaging.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
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